From the Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
Obstet Gynecol. 2011 May;117(5):1105-1113. doi: 10.1097/AOG.0b013e31821188ad.
To estimate 12-month satisfaction and continuation rates of intrauterine device (IUD) and implant users enrolled in the Contraceptive CHOICE Project and compare these measures with women using the oral contraceptive pills (OCPs).
We analyzed 12-month data from the first 5,087 participants enrolled in a prospective cohort study of women in the St. Louis region offered contraception at no cost for 3 years. The primary purpose of CHOICE is to promote the use of long-acting reversible contraception (IUDs and implants) and to reduce unintended pregnancies in our region. This analysis includes those participants who received their baseline contraceptive method within 3 months of enrollment and who reached the 12-month follow-up telephone survey time point (n=4,167).
Sixty-eight percent of our participants chose a long-acting reversible contraception method (45% levonorgestrel intrauterine system, 10% copper IUD, and 13% subdermal implant), 23% chose combined hormonal methods (11% OCPs, 10% vaginal ring, and 2% transdermal patch), and 8% chose depot medroxyprogesterone acetate. Long-acting reversible contraception users had higher 12-month continuation rates (86%) than OCP users (55%). The two IUDs had the highest 12-month continuation rates: levonorgestrel intrauterine system (88%) and copper IUD (84%). Women using the implant also had very high rates of continuation at 1 year (83%). Satisfaction mirrored continuation: more than 80% of users were satisfied with the IUD compared with 54% satisfied with OCPs.
IUDs and the subdermal implant have the highest rates of satisfaction and 12-month continuation. Given that long-acting reversible contraception methods have the highest contraceptive efficacy, these methods should be the first-line contraceptive methods offered to patients.
评估参与避孕选择计划（Contraceptive CHOICE Project）的宫内节育器（IUD）和植入物使用者的 12 个月满意度和续用率，并将这些措施与使用口服避孕药（OCPs）的女性进行比较。
我们分析了在圣路易斯地区提供为期 3 年免费避孕服务的前瞻性队列研究中首次入组的 5087 名女性的 12 个月数据。CHOICE 的主要目的是推广长效可逆避孕方法（IUD 和植入物），并减少我们地区的意外怀孕。本分析包括在入组后 3 个月内接受基线避孕方法且达到 12 个月随访电话调查时间点的参与者（n=4167）。
我们的参与者中有 68%选择了长效可逆避孕方法（45%左炔诺孕酮宫内节育系统、10%铜宫内节育器和 13%皮下埋植剂），23%选择了联合激素方法（11%口服避孕药、10%阴道环和 2%经皮贴剂），8%选择了醋酸甲羟孕酮长效避孕针。长效可逆避孕方法使用者的 12 个月续用率（86%）高于口服避孕药使用者（55%）。两种宫内节育器的 12 个月续用率最高：左炔诺孕酮宫内节育系统（88%）和铜宫内节育器（84%）。使用植入物的女性在 1 年内也有非常高的续用率（83%）。满意度与续用率相符：与对口服避孕药满意度为 54%相比，超过 80%的使用者对宫内节育器表示满意。
IUD 和皮下埋植剂具有最高的满意度和 12 个月续用率。鉴于长效可逆避孕方法具有最高的避孕效果，这些方法应作为患者的首选避孕方法。
